Mast Cells in Cardiovascular Disease: From Bench to Bedside

Abstract

Mast cells are pluripotent leukocytes that reside in the mucosa and connective tissue. Recent studies show an increased prevalence of cardiovascular disease among patients with mastocytosis, which is a hematological disease that is characterized by the accumulation of mast cells due to clonal proliferation. This association suggests an important role for mast cells in cardiovascular disease. Indeed, the evidence establishing the contribution of mast cells to the development and progression of atherosclerosis is continually increasing. Mast cells may contribute to plaque formation by stimulating the formation of foam cells and causing a pro-inflammatory micro-environment. In addition, these cells are able to promote plaque instability by neo-vessel formation and also by inducing intraplaque hemorrhage. Furthermore, mast cells appear to stimulate the formation of fibrosis after a cardiac infarction. In this review, the available data on the role of mast cells in cardiovascular disease are summarized, containing both in vitro research and animal studies, followed by a discussion of human data on the association between cardiovascular morbidity and diseases in which mast cells are important: Kounis syndrome, mastocytosis and allergy.

Covid-19 hyperinflammation and post-Covid-19 illness may be rooted in mast cell activation syndrome

“…Among these inflammatory cells, mast cells (MCs) may play an important role because when they recognise viral products, they are activated and synthesise many chemokines and cytokines. In addition, some cytokines secreted by other cells such as T cells, damaged epithelial and endothelial cells (Mukai et al, 2018), or even by themselves (Hermans et al, 2019), stimulate MC activation. MCs regulate the functions of immune cells such as dendritic cells, monocytes/ macrophages, granulocytes, T cells, B cells and NK cells.…”

Mast Cell Degranulation Increases Mouse Mast Cell Protease 4–Dependent Vasopressor Responses to Big Endothelin-1 But Not Angiotensin I

“…Vascular or autoimmune diseases in which inflammatory processes associated with mast cell activation have been documented (Hermans et al, 2019;Kempuraj et al, 2020) and interestingly, also recently reported in post-COVID-19 patients (Afrin et al, 2020). Furthermore, Ahmad et al (2019) suggested that stabilizing mast cells could prevent cardiac remodeling since chymase has a high affinity for the human Ang I peptide, in vitro.…”

Mast cells participate in the development of diastolic dysfunction in diabetic obese mice

“…They are characterized by the expression of c-Kit receptors and by their granules containing active mediators including proteases, notably Cma1, Tpsab1 and histamine. Mast cells may be activated by IgEs via their receptor Fcer1a, Complement factors via Toll-like receptors, IgGs or cytokines 22 . They have been associated with several cardiovascular diseases including atherosclerosis, myocardial infarction and aneurysms 16 , pathologies in which mast cells are contributing to the pathogenesis essentially through the release of their granule content.…”

“…The present study thus confirms the significant role of mast cells in cardiovascular diseases. How mast cells are activated in the setting of cardiovascular diseases remains unknown 22 . We found that, in Lepr db/db mice, increased activation of mast cells is associated with increased circulating levels of IgEs.…”